Monday, October 21, 2013

Hey, Doc: Who Can Sell Me Insurance Through the Marketplace?

We know health reform is big and confusing. Some parts of the law started in 2010. Other parts are rolling out over the next several years. Texas physicians and the Texas Medical Association have carefully studied the law to help you understand what the changes mean to your health care. As the Affordable Care Act (ACA) continues to roll out, Me&My Doctor’s “Hey Doc” series will answer your frequently-asked questions, as well as some you might not have thought to ask. Check out part eight in this series.

Q. Who can sell me insurance through the marketplace?
A. In Texas, you can get to the health insurance marketplace through Healthcare.gov, and that’s where you can find out if you can get help paying for your insurance. To sell insurance in the marketplace, insurance companies must first get the government’s seal of approval on their plans to become what’s called a “qualified health plan.” That means they agree to follow the marketplace rules, like providing a specific level of benefits, limiting the amount you have to spend out of your own pocket, and having networks with enough doctors, hospitals, and other health care providers. You can see a list of approved health plans in Texas at Healthcare.gov, where you can buy your insurance directly. You can also get help with enrollment from a certified navigator or counselor, or a licensed insurance agent or broker approved by the government.

Remember, there is no charge to use Healthcare.gov or enroll in health plans through the marketplace. Federal and state authorities have warned about scams using phony websites, charges, and emails or phone calls, so know what you are buying and from whom you are buying it.

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